| NPI | 1134676687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR RAMOS Owner 708-525-0291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071007888) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-09-29 |